126 articles - From Friday May 13 2022 to Friday May 20 2022
Guidelines, position statements, white papers, technical reviews, consensus statements, etc…
| Clin Gastroenterol Hepatol |
Adenoma and Sessile Serrated Lesion Detection Rates at Screening Colonoscopy for Ages 45-49 Years vs. Older Ages Since the Introduction of New Colorectal Cancer Screening Guidelines. In our healthcare system, a lower CRC screening initiation age has modestly affected colonoscopy volume by age without compromising screening yield. Lesion detection rates, including for advanced adenomas, in average-risk 45-49 year-olds approximate those in 50-54 year-olds at first-time screening, and 60-64 year-olds at re-screening. National monitoring is needed to assess fully the impact of lowering the CRC screening initiation age. |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
BENEFIT OF EXTENDED SURVEILLANCE OF LOW-RISK PANCREATIC CYSTS AFTER FIVE-YEAR STABILITY: A SYSTEMATIC REVIEW AND META-ANALYSIS. A lower incidence of advanced neoplasia during extended surveillance among low-risk, stable-sized BD-IPMNs is a key finding of this study. However, the survival benefit of surveillance among this population warrants further exploration through high-quality studies before recommending surveillance cessation with certainty. |
| Gastrointest Endosc |
Dye-based chromoendoscopy for the detection of colorectal neoplasia: meta-analysis of randomized controlled trials. This effect was consistent for advanced ADR (RR=1.21[1.03-1.42] I2=0.0%), and for SSA (6.1% vs 3.5%; RR, 1.68; [1.15-2.47]; I2=9.8%), as well as for MAP (MD 0.24 [0.17-0.31]) overall and in the right colon (MD, 0.28 [0.14-0.43]. High-definition white-light colonoscopy (HDWL) was more effective than standard white-light colonoscopy (SDWL) for detection of adenomas (51.6% 95% CI:47.1-56.1% vs 34.2%; 95% CI:28.5-40.4%) and DBC (59.1%; 95% CI:54.7-63.3%) was more effective than HDWL (RR=1.14; 95% CI:1.06-1.23, I2= 0.0%]. Meta-analysis of RCTs showed that DBC increases key quality parameters in colonoscopy, supporting its use in every-day clinical practice. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Clinical trial: intra-dermal hepatitis B vaccination with topical imiquimod versus intra-muscular hepatitis B vaccination in inflammatory bowel disease patients. Intradermal hepatitis B vaccination with topical imiquimod pre-treatment is safe and offers superior seroprotection to conventional IM administration in IBD patients. |
Non-oesophageal eosinophilic gastrointestinal diseases are undersuspected clinically and underdiagnosed pathologically. Gastroenterologists and pathologists commonly address and diagnose EoE. In contrast, both clinical suspicion and diagnosis of non-oesophageal EGID are extremely rare. Increased clinical awareness might result in a better understanding of the epidemiology and improved diagnosis of these still elusive conditions. |
Pregnancy outcomes following periconceptional or gestational exposure to ustekinumab: Review of cases reported to the manufacturer's global safety database. Rates of adverse pregnancy outcomes or CAs with ustekinumab exposure from JGSD are consistent with rates reported for the US general population and do not suggest a higher risk associated with maternal or paternal exposure to ustekinumab. |
The impact of red blood cell transfusion practices on inpatient mortality in variceal and non-variceal gastrointestinal bleeding patients: A 20-year US nationwide retrospective analysis. Mortality for upper GI bleeding has been declining since 1999. Although decreased over the last decade, PRBC transfusion rates remain high for variceal bleeders. In addition, PRBC transfusion appears to be more detrimental in variceal bleeders than in non-variceal bleeders. |
| Am J Gastroenterol |
"Doctor, what's the best Crohn's therapy?" Comparative effectiveness methodology allows for indirect comparisons of agents based on the outcome of interest. When deciding what agent is "best" for any specific patient, multiple factors have to be taken into consideration including the primary outcome of interest. Here the outcome of mucosal healing is considered. |
Novel Endoscopic Polypectomy Surveillance Technique for Fundic Gland Polyps in Familial Adenomatous Polyposis Can Improve Early Detection of Dysplasia and Gastric Cancer. We identified that the incidence of dysplasia and GC is higher than previously reported in FAP patients. Our study utilized a novel EPS technique and was able to identify GC within the foci of FGPs. Upper endoscopic guidelines should include a more rigorous sampling method for FGPs, such as EPS, to optimize early detection of dysplasia and gastric cancer. |
| Clin Gastroenterol Hepatol |
Inverse association between gluteofemoral obesity and risk of non-cardia gastric intestinal metaplasia. The independent dimensions of adiposity (BMI, waist circumference) are not associated with increased risk of non-cardia gastric intestinal metaplasia. The inverse association between gluteofemoral obesity and risk of gastric intestinal metaplasia warrants additional study. |
Patient Navigation Increases Linkage to Care and Receipt of Direct-Acting Antiviral Therapy in Patients with Hepatitis C. Patient navigation was associated with significantly increased linkage to care and treatment initiation among HCV-infected patients. Patient navigation programs can be used to promote HCV elimination among traditionally difficult-to-reach patient populations. |
Three-fold increased risk of death in Budd-Chiari syndrome compared to matched controls: A population-based cohort study. Patients with BCS in Sweden had a three-fold higher risk of death compared to general population reference individuals. While mortality from liver diseases was high in relative terms, most patients died from cardiovascular causes. |
| Endoscopy |
An artificial intelligent difficulty scoring system in stones removal during endoscopic retrograde cholangiopancreatography: a prospective validation. The CAD system can effectively assess and classify the extent of technical difficulty in endoscopic stone extraction during ERCP. Besides, it automatically provides a quantitative evaluation of CBD and stones, which in turn would help endoscopists to apply suitable procedures and interventional methods to minimize the possible risks of endoscopic stone removal. |
Artificial intelligence assisted optical diagnosis for resect and discard strategy in clinical practice (Artificial intelligence BLI Characterization; ABC study). AI-assisted OD matches the required PIVI thresholds. However, this does not offset the need for a high-level confidence and expertise by the endoscopist. The AI system seems to be useful especially for non-experts. |
Clinical Trial Transparency in Gastrointestinal Endoscopy Research. Compared to other fields in medicine, endoscopy clinical trials have a high rate of clinical trial transparency. However there is room for improvements as close to one-fifth of trials fail to report results and 81.8% do not report results to ClinicalTrials.gov. |
| Gastroenterology |
Endoscopic versus surgical step-up approach for infected necrotizing pancreatitis (ExTENSION): long-term follow-up of a randomized trial. At long-term follow-up, the endoscopic step-up approach was not superior to the surgical step-up approach in reducing death or major complications in patients with infected necrotizing pancreatitis. However, patients assigned to the endoscopic approach developed overall fewer pancreaticocutaneous fistulas and needed fewer re-interventions after the initial 6-months follow-up. Netherlands Trial Register no NL8571. |
Impact of the COVID-19 pandemic on fecal immunochemical testing, colonoscopy services, and colorectal neoplasia detection in a large United States community-based population. The pandemic led to fewer FIT screenings and colonoscopies in 2020 versus 2019; however, after the lifting of shelter-in-place orders, FIT screenings exceeded, and colonoscopy volumes nearly reached numbers from those same months in 2019. Overall, there was an 8.7% reduction in CRC cases diagnosed by colonoscopy in 2020. These data may help inform the development of strategies for CRC screening and diagnostic testing during future national emergencies. |
Induction of FGFR4 by H. pylori via STAT3 with a feedforward activation loop involving SRC signaling in gastric cancer. Our findings demonstrated a link between infection, inflammation and FGFR4 activation where a feedforward activation loop between FGFR4 and STAT3 is established via SRC in response to H. pylori infection. Given the relevance of FGFR4 to the etiology and biology of gastric cancer, we propose FGFR4 as a druggable molecular vulnerability that can be tested in gastric cancer patients. |
| Gastrointest Endosc |
Assessment of Submucosal Distortion and Mass Effect Seen at Follow-up After Colorectal Endoscopic Mucosal Resection with ORISE. ORISE can cause submucosal distortion in the region of EMR scars when they are viewed at follow-up. Such distortions must not be mistaken for submucosal tumor growth. |
Risks of refractory chest pain after peroral endoscopic myotomy in achalasia-related esophageal motility disorders: short-term results from a multicenter study in Japan. The prevalence and severity of chest pain were dependent on age, sex, disease duration, prior treatment, and esophageal morphology, rather than HRM findings. The efficacy of POEM is satisfactory; however, residual pain was often observed. Excessively long myotomy can be avoided, and anterior myotomy may be recommended. |
| Gut |
Comparison of biochemical, microbial and mucosal mRNA expression in bile acid diarrhoea and irritable bowel syndrome with diarrhoea. Though sharing clinical symptoms with IBS-D, BAD is associated with biological differences and mechanisms that have potential to enhance diagnosis and treatment targeting barrier dysfunction, inflammatory and microbial changes. |
Interferon regulatory factor 1 (IRF1) controls the metabolic programmes of low-grade pancreatic cancer cells. IRF1 links endodermal differentiation to the expression of genes controlling antigen presentation and processing as well as to the specification of the metabolic profile characteristic of classical PDAC cells. |
Novel microenvironment-based classification of intrahepatic cholangiocarcinoma with therapeutic implications. We describe a comprehensive TME-based stratification of iCCA. Cross-species analysis establishes murine models that align closely to human iCCA for the preclinical testing of combination strategies. |
| Hepatology |
Genetic modifiers of penetrance to liver endpoints in HFE hemochromatosis: associations in a large community cohort. HFE p.C282Y homozygote penetrance to clinical disease in a large community cohort was partly explained by common genetic variants that influence iron and risks of related diagnoses in the general population. Including polygenic scores in HH screening and diagnosis may help in estimating prognosis and treatment planning. |
Impact of Bacterial Infections and SBP Prophylaxis on Phage-Bacterial Dynamics in Cirrhosis. In cirrhosis, there are significant changes in phage-bacterial linkages in infected patients and those on SBP prophylaxis compared to the remaining patients. SBP prophylaxis enriches complexity of E.faecium-centered but induces a collapse in E.coli-centered phage-bacterial correlations. |
Liver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome. SARS-CoV-2 vaccination can be associated with liver injury. Corticosteroid therapy may be beneficial in those with immune-mediated features or severe hepatitis. Outcome was generally favorable, but vaccine associated liver injury led to fulminant liver failure in one patient. |
Metabolic reprogramming of the intestinal microbiome with functional bile acid changes underlie the development of NAFLD. These novel findings demonstrate a role for bile acids and the bile acid dependent microbiome in the development and progression of NAFLD and set the stage to leverage these findings for NASH biomarker development and for therapeutics. |
Multiomics identifies the link between intratumor steatosis and the exhausted tumor immune microenvironment in hepatocellular carcinoma. Multiomics stratified nonviral HCCs according to prognosis or TIME. We identified the link between intratumoral steatosis and immune-exhausted immunotherapy-susceptible TIME. |
Nonalcoholic Fatty Liver Disease and Accelerated Loss of Skeletal Muscle Mass: A Longitudinal Cohort Study. When participants with NAFLD were further divided by NAFLD severity, ASM loss was much faster in participants with NAFLD with intermediate to high NFS than in those with low NFS. Participants with NAFLD were at increased risk of sarcopenia, indicated by faster loss of skeletal muscle mass. Patients with NAFLD may need screening and early intervention to mitigate skeletal muscle mass loss. |
Nonalcoholic Fatty Liver Disease Risk and Histologic Severity are Associated with Genetic Polymorphisms in Children. This study demonstrated novel disease-associated SNPs in children with NAFLD. In particular, rs6006473 was highly associated with severity of fibrosis. These hypothesis-generating results support future mechanistic studies of development of adverse outcomes such as fibrosis and generation of therapeutic targets for NAFLD in children. |
PP2 protects from keratin mutation-associated liver injury and filament disruption via SRC kinase inhibition in male but not female mice. PP2 protects, in a male-selective manner, keratin mutation-induced mouse liver injury by inhibiting SRC-triggered downstream Ser/Thr phosphorylation of K8/K18, which is phenocopied by RAF kinase inhibitor vemurafenib. The PP2/vemurafenib-associated findings, and their unique mechanisms of action, further support the potential role of select kinase inhibition as therapeutic opportunities for keratin and other IF-associated human diseases. |
| Inflamm Bowel Dis |
Comparison of Performances of Adalimumab Biosimilars SB5, APB501, GP2017, and MSB11022 in Treating Patients with Inflammatory Bowel Diseases: A Real-Life, Multicenter, Observational Study. Adalimumab biosimilars are effective and safe in IBD treatment, both in new patients and in patients switched from the ADA originator. No difference in efficacy and safety was found between ADA biosimilars. |
Genetic Profiling of Colorectal Carcinomas of Patients with Primary Sclerosing Cholangitis and Inflammatory Bowel Disease. The excess risk of CRC in patients with PSC-IBD was not explained by copy number aberrations, mutations, MSI, nor CIMP status, in cancer tissue, nor in adjacent mucosa. These findings set the stage for further exome-wide and epigenetic studies. |
High Prevalence of Malnutrition and Micronutrient Deficiencies in Patients With Inflammatory Bowel Disease Early in Disease Course. Patients with recently diagnosed IBD have a high prevalence of malnutrition and micronutrient deficiencies. Both the Malnutrition Universal Screening Tool and Saskatchewan IBD Nutrition Risk Tool can be used to identify those at increased risk of malnutrition. Future studies and screening tool development are necessary to identify those at risk of developing malnutrition to facilitate timely referral for nutritional evaluation and prevent disease related complications. |
Lipid Changes After Induction Therapy in Patients with Inflammatory Bowel Disease: Effect of Different Drug Classes and Inflammation. Lipid changes remained after adjusting for age and CRP. Prednisone and tofacitinib induction therapy significantly increase serum lipid levels, whereas no changes were observed in other drug classes. The observations seem drug-specific inasmuch as adjustment for systemic inflammation did not alter the results. |
Low Fecal Calprotectin Predicts Histological Healing in Patients with Ulcerative Colitis with Endoscopic Remission and Leads to Prolonged Clinical Remission. Fecal calprotectin < 82 µg/g predicts HH in patients with UC with clinical and endoscopic remission. Low FC leads to prolonged CR, equivalent to HH. |
Multimodal Brain MRI of Deep Gray Matter Changes Associated With Inflammatory Bowel Disease. The volume of the thalamus was positively correlated with CRP concentration and was increased in females experiencing pain. Patients with IBD exhibit functional and structural changes in the limbic and striatal systems. These changes may be targets for assessing or predicting the response to therapeutic interventions aimed at improving comorbid emotional and cognitive symptoms. |
The Impact of Periodontitis on Inflammatory Bowel Disease Activity. Periodontitis and tooth loss were significantly associated with increased IBD-related disability and more disease activity in the preceding 12 months. Our results suggest that greater attention should be paid to IBD patients' oral health. |
| J Crohns Colitis |
Escherichia coli strains from patients with inflammatory bowel diseases have disease-specific genomic adaptations. Comparative genomics indicates that E. coli is a commensal species adapted to the overly-active mucosal immune milieu in IBD, rather than causing it. Our results reveal mutations that may lead to attenuated antigenicity in some E. coli strains. |
Multicriteria Decision Analysis for Updating of Quality Indicators for Inflammatory Bowel Disease Comprehensive Care Units in Spain. This updated set of QIs comprises a weighted and prioritized set of items that represent the essential minimum criteria for ensuring appropriate quality of care in the management of IBD patients. |
| J Hepatol |
Hepatoblastomas with carcinoma features represent a biological spectrum of aggressive neoplasms in children and young adults. Our single-institution study suggested that histological features seen in HBCs are associated with combined HB and HCC molecular features, that HBCs have poor outcomes irrespective of patient age, and that transplanted HBCs are more likely to have good outcomes than HBCs that are treated with chemotherapy and surgery alone. These findings highlight the importance of molecular testing and early therapeutic intervention for aggressive childhood hepatocellular neoplasms. |
| Neurogastroenterol Motil |
Cine gastric MRI reveals altered Gut-Brain Axis in Functional Dyspepsia: gastric motility is linked with brainstem-cortical fMRI connectivity. Our multi-modal MRI approach revealed lower peristaltic propagation velocity linked to altered brainstem-cortical functional connectivity in patients suffering from FD suggesting specific plasticity in gut-brain communication. |
Three dimension high-definition manometry in evaluation of anorectal function in 104 normal infants and children: A clinical study from China. Anal canal function parameters gradually increased with age in normal infants and children which demonstrated the important role of age in evaluation, and these parameters can provide a reference for postoperative evaluation of anal canal function. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: current and emerging therapies for acute alcohol-associated hepatitis. Corticosteroid therapy for alcohol-associated hepatitis is restricted in its applicability and has limited efficacy. Developing multidisciplinary, patient-centred care models based on digital health technologies, in combination with continued discovery of novel therapies using multiomics data and computational biology techniques will be necessary to tackle the increasing burden of alcohol-associated hepatitis. |
| Clin Gastroenterol Hepatol |
| Gut |
Clinical relevance of biomarkers in cholangiocarcinoma: critical revision and future directions. With the present paper, a multidisciplinary group of experts within the European Network for the Study of Cholangiocarcinoma discusses the clinical role of tissue biomarkers and provides a selection based on their current relevance and potential applications in the framework of CCA. Recent advances are proposed by dividing biomarkers based on their potential role in diagnosis, prognosis and therapy response. Limitations of current biomarkers are also identified, together with specific promising areas (ie, artificial intelligence, patient-derived organoids, targeted therapy) where research should be focused to develop future biomarkers. |
| Hepatology |
Beyond circadian rhythms: Emerging roles of ultradian rhythms in control of liver functions. In this review, we will first very briefly discuss the basic principles of circadian rhythms, and then cover in greater details the recent literature related to ultradian rhythms. Specifically, we will highlight the prevalence and mechanisms of hepatic 12-hour rhythms, and 8-hour rhythms, which cycle at the second and third harmonics of circadian frequency. Finally, we also refer to ultradian rhythms with other frequencies and examine the limitations of the current approaches as well as the challenges related to identifying ultradian rhythm and addressing their molecular underpinnings. |
| J Crohns Colitis |
Blockade of IL-23: What is in the Pipeline? Studies on preclinical models and observations of other immune-mediated diseases, such as psoriasis, suggest that the selective inhibition of IL-23 could be beneficial in IBD. Four monoclonal antibodies [risankizumab, mirikizumab, brazikumab and guselkumab] are currently in advance clinical trials for either CD or UC. In this review, we provide an overview of the main results from published studies of selective anti IL-23 agents. |
IL-23 Blockade in Anti-TNF Refractory IBD: From Mechanisms to Clinical Reality. We focus on and assess available clinical trial data of the emerging substance class of IL-23p19 inhibitors, which have demonstrated remarkable efficacy not only in anti-TNF-naïve but also refractory patients. We present molecular mechanisms that drive IL-23-mediated resistance to ongoing anti-TNF therapy and discuss the dynamic fluidity of the mucosal cytokine network in the course of therapy that perpetuates the mucosal inflammatory reaction. Translation of these findings into clinical practice might finally lead to initiation of the most appropriate therapy at the right time of the individual disease course, which would have important implications for the patient's probability of response to treatment. |
IL-23 Monoclonal Antibodies for IBD: So Many, So Different? Blockade of both IL-12 and IL-23 using an antibody that targets a shared subunit is highly effective in treating psoriasis, and recent data suggest similar efficacy in IBD with minimal adverse events. In this review, we summarise published data on the efficacy of anti-IL-12/23 therapies in IBD as well as emerging data on more selective anti-IL-23 specific therapies. Last, we discuss novel therapeutics under development which target the IL-23 pathway in unique ways and suggest that a biomarker-driven approach will soon guide clinicians to prescribe anti-IL-23 therapies to the patients most likely to respond to them. |
Interleukin-23 in the Pathogenesis of Inflammatory Bowel Disease and Implications for Therapeutic Intervention. The relative importance of the diverse immunological pathways downstream of IL-23 in propagating mucosal inflammation in the gut, however, remains contentious. Here we review current understanding of IL-23 biology and explore its pleiotropic effects on T cells, and innate lymphoid, myeloid and intestinal epithelial cells in the context of the pathogenesis of IBD. We furthermore discuss these pathways in the light of recent evidence from clinical trials and indicate emerging targets amenable to therapeutic intervention and translation into clinical practice. |
Ustekinumab in Crohn's Disease: New Data for Positioning in Treatment Algorithm. It showed to be effective and safe in randomised clinical trials and real-life studies and is currently approved for the management of CD patients who are naive to biologics and those who have already been treated with such medications. However, to date, a detailed and approved therapeutic algorithm is not available. The aim of this review is to report the most recent and updated data on the efficacy and safety of ustekinumab for the treatment of patients with moderate to severe CD and to define the optimal management of these patients. |
What Can IBD Specialists Learn from IL-23 Trials in Dermatology? Anti-IL-23 indication for psoriatic arthritis is very recent and for IBD is still to come. Therefore, dermatologists are accumulating long-term experience with these drugs, both in clinical trials and in real-world evidence, which can help gastroenterologists in the management of IBD patients. |
| J Hepatol |
"Beyond MELD" - Emerging strategies and technologies for improving mortality prediction, organ allocation and outcomes in liver transplantation. In this review article, we discuss the model for end-stage liver disease (MELD) score and its dual purpose in general and transplant hepatology. As the landscape of liver disease and transplantation has evolved considerably since the advent of the MELD score, we summarise emerging concepts, methodologies, and technologies that may improve mortality prognostication in the future. Finally, we explore how these novel concepts and technologies may be incorporated into clinical practice. |
Artificial intelligence for the prevention and clinical management of hepatocellular carcinoma. A growing body of recent data now apply DL models to diverse data sources - including electronic health record data, imaging modalities, histopathology and molecular biomarkers - to improve the accuracy of HCC risk prediction, detection and prediction of treatment response. Despite the promise of these early results, future research is still needed to standardise AI data, and to improve both the generalisability and interpretability of results. If such challenges can be overcome, AI has the potential to profoundly change the way in which care is provided to patients with or at risk of HCC. |
Breakthroughs in therapies for NASH and remaining challenges. This generated efficacy results for a number of highly promising compounds that are now in late-stage development. Intense research aimed at further improving the assessment of histological endpoints and in developing non-invasive predictive biomarkers is underway. This will help improve the design and feasibility of successful trials, ultimately providing patients with therapeutic options that can change the course of the disease. |
Haemostatic alterations and management of haemostasis in patients with cirrhosis. This paper will outline recent advances in pathogenesis, prevention and treatment of both bleeding and thrombotic complications in patients with cirrhosis. Among other topics, we will discuss the haemostatic status of acutely ill patients with cirrhosis, the various causes of bleeding in patients with cirrhosis, and how best to prevent or treat bleeding. In addition, we will discuss the hypercoagulable features of patients with cirrhosis, new insights into the pathogenesis of portal vein thrombosis, and how best to prevent or treat thromboses. |
How to achieve functional cure of HBV: Stopping NUCs, adding interferon or new drug development? These novel approaches may be further combined with NUCs or PEG-IFNa in personalised strategies, according to virologic and disease characteristics, to maximise the chance of HBV cure. The development of curative HBV therapies should be coupled with the development of standardised and validated virologic and immunologic assays to confirm target engagement and to assess response. In addition to efficacy, curative therapies must be safe and affordable to meet the goal of global elimination of hepatitis B. |
Impact of non-invasive biomarkers on hepatology practice: Past, present and future. Non-invasive approaches are based on the quantification of biomarkers in serum samples or on the measurement of liver stiffness, using either ultrasound- or magnetic resonance-based elastography techniques. The fibrosis-4 index (non-patented) and enhanced liver fibrosis test (patented) are the most widely adopted serum markers, whereas vibration-controlled transient elastography is the most widely adopted elastography technique. In this review, we discuss the role of non-invasive tests in the current era, as well as their accuracy and how their use in clinical practice has changed the practice of hepatology, including identification of early cirrhosis in patients with risk factors for CLD, diagnosis of portal hypertension, establishing prognosis in compensated cirrhosis, guiding antiviral treatment, and screening for fibrosis and cirrhosis in primary care. |
Long-term albumin treatment in patients with cirrhosis and ascites. Further clinical studies and randomised trials are warranted to confirm the clinical benefits of long-term albumin therapy. Important areas for further research include determining the precise target population, the biomarkers of response, the optimal dose and frequency of albumin infusions, the stopping rules, and the cost-effectiveness of treatment in different healthcare systems across the world, particularly in those where the logistical issues and costs related to the periodic intravenous infusions may represent an important limitation to the implementation of this innovative approach in clinical practice. In this review, we will critically analyse the available data on long-term albumin treatment, focusing on the differences that exist between studies, the controversial issues and the future perspectives. |
Modern therapeutic approaches to liver-related disorders. Loss-of-function mutations might also be treated with enzyme substitution therapy. This review summarises current genetic approaches as well as key enzyme substitution therapies, focusing on recently approved compounds, potential adverse effects, and future challenges. Collectively, these recent advances place the liver at the forefront of precision medicine for metabolic and genetic diseases and are expected to transform the care and treatment of patients with both liver-specific and systemic diseases. |
Promises of microbiome-based therapies. Preclinical models demonstrate the importance of the gut microbiota in the pathogenesis of various liver diseases. In this review, we discuss how manipulation of the gut microbiota can be used as a novel treatment approach for liver disease. We summarise current data on untargeted approaches, including probiotics and faecal microbiota transplantation, and precision microbiome-centered therapies, including engineered bacteria, postbiotics and phages, for the treatment of liver diseases. |
Protective mechanisms and current clinical evidence of hypothermic oxygenated machine perfusion (HOPE) in preventing post-transplant cholangiopathy. This unique feature prevents mitochondrial oxidative injury and further downstream tissue inflammation. HOPE treatment therefore supports livers by protecting them from ischaemia-reperfusion injury (IRI), and thereby also prevents the development of post-transplant biliary injury. With reduced IRI-associated inflammation, recipients are also protected from activation of the innate immune system, with less acute rejections seen after HOPE. |
The essential requirements for a HPB center to deliver high quality outcomes. We propose criteria for essential requirements for a HPB center to deliver high quality outcomes, with the concept of "center of reference" limited to actual, in opposition to virtual, centers. LAY SUMMARY: After a comprehensive literature review and a large international survey, we present the requirements for HPB center to deliver quality outcomes. The worldwide survey showed that there is a need for "re-designing" HPB centers, as only one third of surveyed centers meet most of the criteria. |
Therapeutic advances in alcohol-associated hepatitis. Meanwhile, the broader medical field has seen a transformation in care paradigms based on emerging digital technologies. This review focuses on breakthroughs in our understanding of AH and how these breakthroughs are leading to new paradigms for biomarker discovery, clinical trial activity, and care models for patients. It portends a future in which multimodal data from genetic, radiomic, histologic, and environmental sources can be integrated and synthesised to generate personalised biomarkers and therapies for patients with AH. |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| Hepatology |
| J Hepatol |
all remaining publications eg case reports, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
| Hepatology |
| Inflamm Bowel Dis |
| J Hepatol |
| Neurogastroenterol Motil |